Home Health Referrals – You can make a referral for yourself or a family member.

If your physician agrees you would benefit from home health, he/she will make a referral to a certified home health agency and will authorize a treatment plan, commonly called a plan of care. Referrals most often start with a phone call.

In general, you will have 4 main referral sources to cultivate.

• Primary Care Doctors refer patients who ASK the doctor about home care, often times this is through their social worker or office manager
• Care Managers
• Social Workers
• Discharge Planners REFER patients leaving the hospital

To qualify for home health care, you must meet the following criteria:

• Be considered “homebound”, based on the Centers for Medicare & Medicaid (CMS) criteria
• Require skilled care on a part-time or intermittent basis to improve, maintain, prevent, or further slow your health condition
• Be under the care of a doctor, who completes and documents an in-person visit with you either: three months before the start of HHC, or within one month after the HHC benefit has begun

Receive HHC from a Medicare-approved home health agency. But what exactly does that mean?

Well, let’s say you end up in the hospital after a fall and get surgery on your knee. After spending at least 3 days in the hospital it’s time to get discharged, but you have not completely healed from your injury. The discharge documents from your physician will include information about you being homebound and needing short-term skilled care. The documents will also include a plan of care that notifies Medicare and health care agencies of the services and equipment you will need while being cared for.

Once this happens you are now eligible to receive home health care from a Medicare-approved agency.